Drug Abusers, Smokers More Likely to Use Opioids Long-Term

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1 July 2015. A study by the Mayo Clinic finds people with a history of substance abuse and using tobacco are those most at risk for using opioid pain killers on a continuous basis. The team led by Michael Hooten, an anesthesiologist at Mayo Clinic in Rochester, Minnesota, published its findings in the July issue of the Mayo Clinic Proceedings.

Opioids work by reducing the intensity of pain signals to the brain, particularly regions of the brain controlling emotion, which reduces effects of the pain stimulus. Examples of leading opioid prescription pain medications are hydrocodone, oxycodon, morphine, and codeine.

Abuse of opioid pain killers is described by Centers for Disease Control and Prevention as a growing epidemic, fueled in part by growing numbers of prescriptions written for pain killing drugs. CDC reports that in 2012, physicians in the U.S. wrote 259 million prescriptions for pain killers, enough for one bottle of pills for every adult in the country. As of July 2014, according to the CDC, 46 people die each day in the U.S. from an overdose of prescription pain killers. The 10 states with the highest rates of prescriptions for pain killers, says CDC, are in the South.

Hooten and colleagues looked into the types of people receiving prescriptions for pain killers to identify patterns and characteristics of those most likely to end up using the drugs on a long-term basis. The Mayo Clinic team took advantage of a database of common electronic health records in its own region, the Rochester Epidemiology Project that compiles for researchers decades of medical records from tens of thousands of individuals in southeastern Minnesota.

The Mayo Clinic team drew a sample of 293 individuals who received a new prescription for opioid pain killers in 2009. The researchers then reviewed further use of opioids by people in the sample for 1 year, classifying their use of the drugs as short-term, episodic, or long-term.

The researchers found the 293 individuals received 515 prescription for pain killers in 2009, with about 1 in 5 (21%) showing a pattern of episodic use and 6 percent becoming long-term opioid users. The team also found people who use tobacco and those with a history of substance abuse were more highly correlated with episodic and long-term opioid prescribing pattern.

“From a patient perspective, it is important to recognize the potential risks associated with these medications,” says Hooten in a Mayo Clinic statement. “I encourage use of alternative methods to manage pain, including non-opioid analgesics or other non-medication approaches. That reduces or even eliminates the risk of these medications transitioning to another problem that was never intended.”

Hooten tells more about the study in the following video.

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